On Immigration, and Bans, and My Responsibility to My Patients

On Immigration, and Bans, and My Responsibility to My Patients

A patient came to see me in the sexual health clinic. An academic pathologist in Lebanon, she had been diagnosed with endometrial cancer a few years earlier. Her son was in college in Boston, and fortunately, she had the means to travel to the United States for care. She underwent surgery here and then completed radiation and chemotherapy for locally advanced disease. Now, 3 years later, she had entered a (so far) enduring remission.

However, her treatment had come with a cost: she had been unable to have intercourse. Attempts caused significant pain, and the inability to engage in a sexual relationship with her husband had caused strain in her marriage, and stress on herself—she felt “less than woman” due to the perceived “failure” in her ability to function as wife.

We spent a long time discussing sexual health and the complexity of women’s sexual function, particularly for women with cancer who experience a sudden and unexpected change in their ability to be sexually active due to treatment. I told her how common this was and we reviewed options to increase comfort during penetration and ways we could address the loss of intimacy between her and her husband. She and I made plans to meet again in 2017, the next time she planned to be in Boston.

At that next visit she was notably anxious. It was not her cancer, nor was it about sexual health. She was anxious about the new administration and our new President. She followed the rhetoric against Muslims and the talk of a travel ban. At that time, I assured her that her care would be unaffected—that I would still be her doctor and see her each time she was in the U.S., that at MGH and especially, in this clinic, nothing had changed. As we wrapped up that visit, I asked when she would be back in Boston.

“I don’t know,” she said. “It will depend on what happens. There is talk that the new administration will be instituting a ban.”

We looked at each other then. I did not know what to say, and I had no reassuring words or guarantees that the U.S. would remain open to her and to others from the Middle East.

“Well, no matter what the future holds politically,” I told her, “you are a patient here, and you are a patient of mine. That will never change.”

That encounter remains fresh in my mind given the current events from the new administration. As soon as the ban was announced, I worried for my patients and for my colleagues. I worried that medical care would be denied to international patients, including those who came to the U.S. for cancer care. Fortunately for my patient, Lebanon was not included in the travel ban, but still, I worried.

Recently I travelled to my home on Guam for a cervical cancer conference. It happened to be the weekend after the immigration ban was announced. Although Guam is a U.S. territory and although I am not Muslim, there was a palpable anxiety as passengers cleared Customs and Border Patrol. It might have been irrational, and some might say histrionic. However, I fear an America of “us” versus “them,” particularly because of who I am, and who I am not.

I know there have been varied reactions to ASCO’s statement on the immigration ban. But for me, the son of immigrants from a tiny island in the South Pacific, I am proud of the stance that our professional society has taken. America is a beacon of hope and progress for the world. I hope it remains so.

Disclaimer:

The ideas and opinions expressed on the ASCO Connection Blogs do not necessarily reflect those of ASCO. None of the information posted on ASCOconnection.org is intended as medical, legal, or business advice, or advice about reimbursement for health care services. The mention of any product, service, company, therapy or physician practice on ASCOconnection.org does not constitute an endorsement of any kind by ASCO. ASCO assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the material contained in, posted on, or linked to this site, or any errors or omissions.